Hangover Cures: Myth or Reality?

Is there such a thing as a hangover cure, remedy, or a product which prevents hangovers? We examine the evidence.

Hangovers are poorly understood from a scientific and medical perspective. Scientific researchers have largely neglected the topic of alcohol hangover. There is no theoretical model explaining the pathology of hangovers and thus are poorly understood. Indeed, Joris Verster, the founder of the Alcohol Hangover Research Group, the only group of academic experts dedicated to the science of hangovers, recently stated that “Currently, there is no hangover treatment available of which the effectiveness (or safety) is scientifically proven.”1

However, a recent paper, “Interventions for treatment and/or prevention of alcohol hangover: Systematic Review,” found that several products are “capable of significantly improving some, but not all, of the symptoms” of a hangover.2

Current scientific evidence suggests that the primary causes of a hangover are3:

  • The direct toxic effects of alcohol.
  • The toxic effects of compounds produced by the metabolism of alcohol, especially acetaldehyde and acetate.
  • An imbalance in the immune system after excessive alcohol consumption.

Although there are a lot of so-called old wife’s tales and folk medicine about potential hangover cures and remedies, there is very little scientific evidence or rationale to support the effectiveness of these remedies. Let’s take a look at each of these remedies:

No Drinking

Avoid drinking altogether.

A recent scientific study stated that the ‘most effective way to avoid the symptoms of alcohol induced hangover is to avoid drinking.”4 Well, that one would be one obvious way to prevent a hangover, but that does not really address the fact that people will enjoy a drink or two while socializing.

 

  1. Limit your drinking. No more than one beer, glass of wine, or mixed drink per hour.

Your body metabolizes each drink in about an hour to an hour and 15 minutes.5 If you drink faster than that, your blood alcohol level rises faster and you risk getting a hangover.

 

  1. Avoid drinks with congeners.

Congeners, substances present in alcoholic beverages, which are either naturally-occurring or added during production, particularly methanol, may aggravate the severity of a hangover.6 Wikipedia has an excellent summary of congeners and their relevance to hangovers. Darker liquors like bourbon (which has a total congener content 37 times higher than that of vodka), rum and whiskey contain higher amounts of congeners, while vodka and gin contain much lower amounts of congeners. Indeed, vodka has virtually no more congeners than pure ethanol.

  1. Stay hydrated by drinking a lot of water.

Alcohol suppresses the antidiuretic hormone vasopressin7, which keeps you from peeing too much and regulates your body’s water balance. You could try alternating a glass of water in between beers or mixed drinks. However, there is evidence that dehydration and a hangover are two different, but co-occurring phenomenon. Rather most hangover symptoms arise from the breakdown of alcohol and not from dehydration.

Bloody Mary

  1. Hair of the Dog that bit you.

There is a common belief that consumption of alcohol can somehow prevent the onset of a hangover.8 The idea of that a hangover is a form or acute alcohol withdrawal and that by drinking alcohol the symptoms of this withdrawal will be alleviated. However, just like the relationship between dehydration and hangovers, the signs and symptoms of a hangover and alcohol withdrawal are very different.9 In another theory ascribed to the potential effectiveness of hair of the dog involves the metabolism of methanol.10 As we noted previously, methanol is a congener, a byproduct of alcoholic drink production, and has been correlated with the severity of a hangover. Ethanol and methanol are both metabolized by the body, specifically by the enzyme, alcohol dehydrogenase. However, ethanol is preferentially broken down relative to methanol.11 Hence, drinking more alcohol prevents or delays the metabolism of methanol. Thus, hair of the dog could be merely postponing the symptoms of a hangover and risks getting addicted to alcohol.

  1. Rubbing a lemon under your armpit

We are still researching the origin of this folk remedy (perhaps it originated in the Caribbean?), but needless to say, we do not hold out much hope that this could be an effective hangover remedy.


Bibliography:

  1. Personal Communication.
  2. Jayawardena, Ranil, Thulasika Thejani, Priyanga Ranasinghe, Dinithi Fernando, and Joris C. Verster. "Interventions for treatment and/or prevention of alcohol hangover: Systematic review.Human Psychopharmacology: Clinical and Experimental32, no. 5 (2017): e2600.
  3. C Verster, Joris, and Renske Penning. "Treatment and prevention of alcohol hangover." Current drug abuse reviews3, no. 2 (2010): 103-109.
  4. Verster, Joris C. "The alcohol hangover–a puzzling phenomenon." Alcohol & Alcoholism43, no. 2 (2008): 124-126.
  5. Cederbaum, Arthur I. "Alcohol metabolism." Clinics in liver disease16, no. 4 (2012): 667-685.
  6. J Rohsenow, Damaris, and Jonathan Howland. "The role of beverage congeners in hangover and other residual effects of alcohol intoxication: a review." Current drug abuse reviews3, no. 2 (2010): 76-79.
  7. Penning, Renske, Merel van Nuland, Lies AL Fliervoet, Berend Olivier, and Joris C Verster. "The pathology of alcohol hangover." Current drug abuse reviews3, no. 2 (2010): 68-75.
  8. Verster, Joris C. "The “hair of the dog”: a useful hangover remedy or a predictor of future problem drinking?." Current drug abuse reviews2, no. 1 (2009): 1-4.
  9. Wiese, Jeffrey G., Michael G. Shlipak, and Warren S. Browner. "The alcohol hangover." Annals of internal medicine132, no. 11 (2000): 897-902.
  10. Calder, Ian. "Hangovers: not the ethanol-perhaps the methanol." British Medical Journal314, no. 7073 (1997): 2-4.
  11. Bendtsen, Preben, A. Wayne Jones, and Anders Helander. "Urinary excretion of methanol and 5-hydroxytryptophol as biochemical markers of recent drinking in the hangover state." Alcohol and Alcoholism33, no. 4 (1998): 431-438.